Frequency and specific surgical management of far lateral lumbar disc herniations.
A) Frequency of Far Lateral Lumbar Disc Herniation: The analysis of pre-operative computer-assisted tomograms and myelograms in a series of 694 operated lumbar disc herniations showed that a far lateral disc prolapse occured in 7% of the cases. Within the group of those far laterally herniated discs 3% of the herniations were predominantly located in the intervertebral foramen, whereas 4% of the protruded discs were mainly situated extraforaminally compressing the spinal nerve in its paravertebral course. B) Surgical Management of Extraforaminal Far Lateral Lumbar Disc Herniation: By March 1988 40 patients had been operated on for an extraforaminal disc protrusion making use of an external microsurgical exposure (in two cases by a transmuscular approach and in 38 cases via an enlarged midline approach). A medium-term follow-up of these 40 patients revealed a substantial clinical relief of pain in 34 cases (85%). Based on these gratifying results we regard the external exposure of the extraforaminally protruded disc as the treatment of choice.
Siebner
H R
HR
Neurochirurgische Abteilung, Krankenhaus der Barmherzigen Brüder, Trier, Federal Republic of Germany.
Faulhauer
K
K
D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008866:Microsurgery / Q000379:methods; D009460:Neurologic Examination; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology; D012585:Sciatica / Q000601:surgery; D014057:Tomography, X-Ray Computed